random 3 Flashcards
how frequently do you monitor vitals for peds sedation?
q10m
first step to CPR after drowning
2 rescue breaths
dose of IM succs to break spasm
4mg/kg
brown-sequard syndrome
ipsilateral loss of motor/proprioception at level of injury and contralateral loss of pain/temp 2 levels below
what’s the only type of shock where PCWP (preload) is increased
cardiogenic (backup of fluid)
what’s the only type of shock where SVR (afterload) is decreased?
distributive
what’s IM dose of epi in anaphylaxis
0.3-0.5mg q5-15m
risk factors for nerve injury during spine surgery
obese, male, malnutrition, long hospital stay
where are vasopressin and oxytocin synthesized?
hypothalamus - supraoptic and paraventricular neurons
neuromonitoring during aortic surgeries
tibial nerve most common. volatile suppresses motor more than sensory but motor is more specific. argument against monitoring is wont change clinical course (cant unclamp aorta)
contraindications to extracorporeal shock wave lithotripsy
pregnancy, active UTI, coagulopathy
peds epiglottitis considerations
under deep anesthesia (dont agitate), gas induction sitting up with monitors, IV, no paralytic, lie down, ETT one size smaller, keep tube in 48-72 hours (decrease swelling, air leak).
what’s electrode called that measures oxygen concentration in ABG mchines
clark
sanz - serum pH
severinghaus - co2
enzymatic - glucose
when do you need dental ppx
prostetic valve, valvulopathy after transplant, unrepaired CHD,
dental with manipulation, GI/GU with ongoing infection, infected skin biopsy, respiratory with incision or biopsy
immediate treatment of MVR from chordae tendinae rupture
nitroprusside (arterial vasodilator)
more likely to happen after inferior MI than anterior (perfusion to chordae)
treatment of acute MVR
full, fast, forward
what results in the BIGGEST secretion of vasopressin?
hypotension (decreased stretch at carotid receptor bodies) and then hyperosmolality (sensed by hypothalamus)
first response to NMBA
central (diaphragm, laryngeal) because greater blood flow
BUT diaphragm recovers faster as not as high density of nicotinic ACh receptors
recovery from fastest to slowest
diaphragm
laryngeal
corrugator supercili
abdominal muscles
orbicularis oculi
geniohyoid
adductor pollicis
goals during CPB
CO 1.6-3L
arterial MAPS 50-90
venous O2 >65%
first line treatment for TNS
NSAIDs
isoflorane has coronary vasodilating properties
cool!
acetazolamide does what and causes what
carbonic anhydrase inhibitor works at proximal tubule to prevent reabsorption of bicarb.
decreases pH (via loss of bicarb), compensatory decrease in CO2
indicated if edema AND metabolic alkalosis
what directly stimulates aldosterone?
AT2
(also hypotension, hypoNa, HyperK, hypovolemia)
aldosterone works to increase Na retention
pupillary light reflex?
afferent 2, efferent 3
